For you, from doctors
Weight Gain In Menopause

Weight Gain In Menopause

Many people wonder if weight gain in menopause is common. The truth is that many people going through menopause will gain weight, but it is not due to the process of menopause itself. In general, there is a trend for people to gain weight as they get older. In fact, women gain an average of 1-1.5 pounds per year between the ages of 45 and 60. In the US, almost two-thirds of women between age 40-59, and three-fourths of women over 60 are overweight. There is no good evidence to support metabolism actually slowing down, until the age of 60. During the transition to menopause (called perimenopause), estrogen production decreases, leading to a variety of symptoms such as hot flashes, decreased sexual desire, changes in skin and hair, and other symptoms. Many women also gain weight during this period, but weight gain in mid-life is not necessarily caused by menopause. Instead, weight gain is likely due to age and lifestyle. Regardless of the cause, obesity and overweight are associated with increased risk of cardiovascular and metabolic disease. From pear-shaped to apple-shapedAlthough menopause itself is not thought to cause weight gain, the hormonal changes of perimenopause is correlated with a redistribution of body fat. In fact, estrogen produced by the ovaries causes fat to be stored around the hips, thighs, and buttocks. It is thought that as estrogen decreases, the stores of fat in the body reflect this new ratio of hormones. Many women notice that rather than around the hips, thighs, and buttocks, fat begins to settle around the abdomen.Diet, metabolism, and menopauseAs women age, their metabolism slows, and lean muscle mass decreases. It’s important that they continue to build muscle in order to burn calories more efficiently and to protect bones. Both cardio and strength-training exercises will help to build lean muscle.In addition to decreased muscle mass, women's calorie needs also decrease with age. During their 50s, women need about 200 fewer calories per day than during their 30s and 40s. Eating unprocessed foods rich in nutrients, such as vegetables and lean proteins, helps to satiate hunger without exceeding calorie needs.Some studies have shown that Vitamin D and Omega-3 fatty acids can protect against metabolic disorders and reduce BMI and waist circumference in postmenopausal women. In North America, some foods such as milk and enriched cereals are often fortified with Vitamin D. Foods containing Omega-3 fatty acids include flaxseeds, walnuts, and soybeans as well as seafood. Medical solutions for menopausal weight gainSome studies show that estrogen or estrogen-progestin therapies may decrease the accumulation of total body fat and abdominal fat. However, more studies are needed in order to make evidence-based recommendations on who can benefit from hormone therapies for metabolic health. Talk to your doctor or ob-gyn if you are considering hormone therapies for any menopause-related symptoms.Sourceshttp://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife/changes-in-weight-and-fat-distribution https://www.science.org/doi/10.1126/science.abe5017https://nationalmenopausefoundation.org/weight-gain/ https://www.menopause.org.au/health-info/infographics/maintaining-your-weight-and-health https://www.menopause.org.au/hp/news/weight-loss-and-hot-flush-reduction https://pubmed.ncbi.nlm.nih.gov/22978257/ https://pubmed.ncbi.nlm.nih.gov/31941004/ 
3 min read
Covid-19 Vaccine

Covid-19 Vaccine: Eliminating Misinformation

Despite evidence showing the effectiveness of the Covid-19 vaccine at protecting people from hospital admissions and deaths from Covid infection, there is still a lot of misinformation surrounding Covid-19 and the Covid-19 Vaccine. Here we address some common myths surrounding vaccination.Fact: The COVID-19 vaccine will not affect fertility. During the Pfizer vaccine tests, 23 women volunteers involved in the study became pregnant, and the only one who suffered a pregnancy loss had not received the actual vaccine, but a placebo. On the other hand, not being vaccinated can pose a risk to a healthy pregnancy. There is an increased risk of hospitalization and death in pregnant persons who are unvaccinated and contract Covid-19. This risk also extends to the postpartum period. Additionally, there is a risk to the unborn baby as well. Having COVID-19 during pregnancy increases the risk of delivering a preterm (earlier than 37 weeks) or having a stillborn infant. Fact: Certain populations are more vulnerable to severe consequences from infection with the Covid-19 virus. The risk of being hospitalized, requiring a ventilator and even dying is more common in high risk groups. These groups include people who are older, people with chronic illnesses, The number of deaths among people over the age of 65 is ninety-seven times greater than the number of deaths in people who are 18 to 29 years old (3). BIPOC and Hispanic communities are also more adversely affected by the Covid-19 virus as well as those individuals who have chronic illnesses like cancer, diabetes, heart disease, diseases that make someone immunocompromised, obesity, pregnancy, and sickle cell disease. Vaccination is particularly important in at risk populations.Fact: Having Covid does protect you from future infection in the same robus way that the COVID-19 vaccine does. Being fully vaccinated against Covid-19 is the best protection against the disease. A study done in 2021 showed that in people persons who have had SARS-CoV-2 infection, being fully vaccinated gives additional protection against future reinfection. Therefore, even if you have been previously infected with Covid your risk of getting reinfected is more than two times higher than for those who were infected and got vaccinated.Fact: The mRNA vaccines, made by Pfizer and Moderna COVID-19 vaccines, are very safe and have limited side effect profiles. Some of the side effects include pain at the injection site, fever, headache, and body aches. These side effects typically do not last longer than one or two days. If you are concerned about an allergic reaction to the vaccine, be sure to keep an EpiPen that can help to combat a serious allergic reaction to the vaccine. There has been concern with the Jansenn (Johnson & Johnson) vaccine because there were reported cases of thrombosis with thrombocytopenia syndrome and Guillain-Barré syndrome after getting the Janssen COVID-19 vaccine. Although it was safely administered to the vast majority of people, the CDC stated in December of 2021 that the two mRNA vaccines were preferred (4).Fact: The mRNA vaccines do not change your DNA. Although the messenger RNA from Pfizer and Moderna vaccines do enter cells, they do not enter the nucleus of the cells which is where a cell’s DNA lives (5).Covid-19 has killed millions of people and vaccinations with an mRNA vaccine is one of the best ways to stay healthy. Everyone, and especially at risk populations, should strongly consider becoming fully vaccinated against Covid-19. Sources:
4 min read
Underactive Thyroid Symptoms

Symptoms For Underactive Thyroid (Hypothyroidism)

Our hypothyroidism symptoms checklist below will help you with knowing the signs of having this condition. Hypothyroidism is a condition where the thyroid gland does not make enough thyroid hormone to meet your body’s needs. When this happens, a lot of the body’s functions will slow down.The thyroid is a small butterfly-shaped gland located in the front of the neck. It sends out hormones that can help control how your body uses energy. Since every part of the body uses energy, thyroid hormone plays an important role in the function of almost every organ, including the heart, brain, liver, kidneys, and skin.These symptoms are a generalized group that have been noted in individuals with hypothyroidism in the past, but they overlap with many other diseases. If you have any combination of these symptoms, it does not always mean you have hypothyroidism. Rather, they are an indicator that it might be good to check thyroid function. ●        Fatigue●        Drowsiness●        Depression●        Weight gain●        Fluid retention●        Decreased sweating●        Increased sensitivity to cold●        Dry skin●        Coarse hair with increased hair loss●        Brittle nails●        Constipation ●        Decreased heart rate●        Anemia●        High cholesterol levels  Since the symptoms of hypothyroidism can potentially overlap with hyperthyroidism, other endocrine diseases, or even non-endocrine causes, the best way to know if you have hypothyroidism is to visit your primary care physician or an endocrinologist. By reviewing your blood work and listening to your history, they can accurately diagnose and recommend a plan of care or follow-up.   TSH (thyroid stimulating hormone)TSH is a stimulating hormone released by the pituitary gland. It binds to your thyroid cells and stimulates it to release thyroid hormone. If TSH levels are high, it could indicate hypothyroidism since low thyroid hormone levels will cause the pituitary to release more TSH. T4 & T3T4 and T3 are your thyroid hormones. T4 is the one that is primarily checked, and if its levels are abnormally low*, it indicates hypothyroidism.*Important note- since the “normal” levels of T3 and T4 fall in a very wide range, individuals can have varying definitions of what a “normal” or “abnormal” level is for them. Thyroid antibodiesIf there are thyroid antibodies present in the bloodstream, it can indicate likelihood of an autoimmune disease being the cause of the hypothyroidism.There are many causes of hypothyroidism. Among them are:Hashimoto’s Thyroiditis. The most common form of hypothyroidism is Hashimoto’s thyroiditis. It is an autoimmune disorder where the thyroid is attacked by your own immune cells and over time, your gland may produce less thyroid hormone2.Radiation Treatment. When patients with other medical conditions are treated with radiation in their head or neck, thyroid gland damage can cause it to produce less hormones (3)Congenital Hypothyroidism. Sometimes, babies can have hypothyroidism if they are born with an absent or partially formed thyroid, or if their thyroid cells do not work correctly (3)Pituitary gland damage. The pituitary gland in the brain sends out a hormone (TSH) which tells the thyroid gland how much thyroid hormone (T4 & T3) to make. If the pituitary is damaged by a tumor, radiation, or surgery, it may no longer produce TSH (thyroid stimulating hormone), resulting in the thyroid producing less T4 and T31.Too much or too little iodine. The thyroid gland needs iodine to make thyroid hormone. Having too little or too much iodine in the diet can cause or worsen hypothyroidism3.As outlined above, there are many different causes of hypothyroidism, so be sure to check with your physician to determine the cause. Hypothyroidism is treated by replacing the hormone that your own thyroid is struggling to make, in order to raise the levels of thyroid hormone to what they should be for you. Levothyroxine is a medication that is identical to the hormone that the thyroid normally makes. It comes in the form of a daily pill. The dosage of the medication will vary significantly from person-to-person, since it depends on your body’s specific thyroid levels.Your primary care physician or endocrinologist will require repeat blood work every 3 to 6 months initially in order to keep track of your thyroid hormone levels and adjust the dosage of medication as needed.
4 min read

Sustainable Underwear Brands

Looking to live that sustainable life? With the fashion industry being the second largest contributor to carbon production, even your underwear choices can have a huge impact. While some shop for form (lace, anyone?) and others look at function (no wedgies, please!), underwear is a great place to dip your toe into the world of sustainable and ethical fashion, especially since these are not items you would buy second hand, which is the purest form of sustainability.  Their organic cotton underwear are made with eco-friendly materials including Global Organic Textile Standard cotton and Oeko-Tex certified dye, are made in a Fair Trade Certified factory, and use renewable energy in their supply chain.  They work with an NYC non-profit to recycle old undergarments, turning them into insulation and rug pads. Their body positive sizes range from 2XS to 3XL. Hara means green in Hindi, and these bamboo-based pieces fit the bill of being green.  This Australia-based company focuses on conscious creation of items for their customers and our planet. They reuse most of their offcuts to minimize textile waste, manufacture locally to reduce carbon production, and use low impact non-toxic dyes in all of its products. The company claims to be “Earth’s FavoriteTM Clothing,” and with soft, GOTS cotton and Fair Trade practices, they are well on their way.  80% of their organic cotton comes from India and they keep their production local, which saves energy.  Plus, organic cotton uses 81% less water than conventional cotton.  They offset their carbon production through investments in global wind energy and use post-consumer recycled paper for packaging.  While they have used wool in the past, hemp and elastane are currently the only non-cotton items in any blends.This popular Danish brand only uses biodegradable, recycled, renewable, or natural textiles, as well as employing techniques which reduces waste and increasing fabric resilience. Vegans take note, this does include recycled wool. It uses renewable energy and is an active member of 1% For The Planet, which means they give at least 1% of revenue to environmental causes. They also have a formal statement regarding workers’ rights. With a name like that, this Australian company was made for underwear.  They use organic bamboo, organic cotton, LYOLYTE® (bamboo lyocell), and minimal spandex, all vegan and PETA approved.  The bamboo is grown using rainwater, produces oxygen, and absorbs carbon dioxide.  Once formed into LYOLYTE®, it is biodegradable and compostable and has little water or fabric waste in processing.  Boody audits their factories and partnered factories in China, India, and Vietnam and ensures workers’ safety and living wages.  They use eco-friendly packaging and printing materials.If you want to take it a step further, period underwear is where it’s at.  The average person who menstruates uses around 11,000 disposable period products in their lifetime, while approximately 20 billion sanitary napkins, tampons and applicators are dumped into North American landfills every year.  Period underwear are a comfortable, safe, and sustainable alternative.This brand encompasses Thinx (period underwear), Thinx BTWN (period underwear for teens), and Speax (underwear for bladder leaks). The company’s initiatives include the EveryBody campaign that educates and empowers young people and MAS’ Women Go Beyond initiative at their facility in Sri Lanka.  Their underwear materials are all OEKO-TEX certified to be non-hazardous.Known for its menstrual cups, this B-corp certified company launched period underwear in fall of 2020. Their offerings absorb up to three regular tampons worth of blood and are available in a variety of styles. They use recycled plastic water bottles to make the polyester, which are certified PFAS-free and certified OEKO-TEX. They give 2% back to fund initiatives in education, sustainability, and menstrual health. They are ethically made in Sri Lanka with partners that work to improve their communities by working for things like access to clean drinking water.These brands are just the tip of the iceberg when it comes to sustainable intimates, and companies are based all over the world.  To reduce carbon emissions with shipping, look out for brands based near you!  Hopefully changing to sustainable and ethical underwear will just be the start of your sustainable journey.  Trust me, your nether regions and your planet will thank you!
4 min read

What Cholesterol Is Good?

Cholesterol is an important organic molecule that is essential to forming cellular membranes, producing vitamin D and is involved in making some hormones. It is a type of lipid (fat) that travels through the bloodstream, so having high cholesterol can cause blockage of blood vessels and can increase one’s risk of heart disease. There are both harmful and good types of cholesterol and the two main types are high-density lipoprotein (HDL) and low-density lipoprotein (LDL).HDL is the “good” type of cholesterol that helps remove other forms of cholesterol from your body through the liver. As a result, HDL can protect arteries and prevent plaque build-up in your blood vessels. This type of cholesterol is known as “good cholesterol” and aiming to have higher levels of HDL in your body is beneficial. Women should ideally have levels higher than 55 mg/dL and men should have levels higher than 45 mg/dL. Avoiding smoking, as well as making sure to exercise regularly and eat soluble fiber and healthy fats such as coconut oil and fatty fish are all ways to elevate your HDL levels.LDL cholesterol contributes to plaque formation in blood vessels and can lead to constricted blood flow and partial, or even total, vessel blockages. As a result, this can increase your risk for coronary artery disease, heart attack, and stroke. LDL levels should be lower than 130 mg/dL if you do not have diabetes or atherosclerotic disease, and even lower if you have an underlying condition or a predisposition to having high cholesterol, so it is best to check with your doctor to see what levels are advised specifically for you. In some cases, if you have multiple risk factors your doctor may even advise that your levels are below 100 mg/dL. Cholesterol is only found in animal food sources such as meat, poultry and eggs. Cholesterol intake should not exceed 200 milligrams a day if you are at risk of or predisposed to heart disease. For others without such risks, cholesterol intake should not exceed 300 milligrams a day. If one does have high cholesterol, there are a variety of medications you can take such as statins, fenofibrates and others to lower LDL levels.A cholesterol ratio can be used as a predictor for heart disease. It is calculated by dividing your total cholesterol number by your HDL cholesterol number. For example, if your total cholesterol number is 250 mg/dL and your HDL is 50 mg/dL, your cholesterol ratio would be 5-to-1. Having a higher ratio is indicative of a higher risk of heart disease. Research states that having a cholesterol ratio of less than 5 and around 3.5 is desirable.If you are concerned about your cholesterol levels, getting a blood test is a way to determine your amounts of cholesterol. A complete lipid profile will calculate your total blood cholesterol, LDL cholesterol levels, HDL cholesterol levels and triglyceride levels (triglycerides are another form of fat that stores calories). For total blood cholesterol, less than 200 mg/dL is considered ideal. For LDL cholesterol, less than 100 mg/dL is considered normal. For HDL cholesterol, having more than 40 mg/dL is recommended. For triglycerides, less than 150 mg/dL is considered normal.The National Heart, Lung and Blood Institute (NHLBI) recommends getting a cholesterol screening at 9-11 years of age and repeating it every few years. Men ages 45-55 and women ages 55-65 should receive cholesterol screening every 1-2 years. People over the age of 65 should get tested annually. For people who are at higher risk for coronary diseases, have diabetes, are overweight/obese or are undergoing cholesterol-lowering treatment, talk to your physician about getting tested more regularly.Commonly before a cholesterol blood test, you will be asked to fast for 9-12 hours. Be sure to consult your doctor about the proper pre-testing procedure, as not all levels are affected by fasting.Yes, it is possible to have cholesterol that is too low, but it is much less common than high cholesterol. Low cholesterol has been associated with depression, cancer, and anxiety; however, the relationship between these medical conditions and lower cholesterol needs to be further researched.Cholesterol levels are important for female health as many women are at risk of having high cholesterol, which can directly affect the blood vessels in the heart. This is important to consider as cardiac/heart disease is the leading cause of death in women. A survey found that around 45% of women over the age of 20 have elevated total cholesterol levels of 200 mg/dL or above. However, many women do not know their cholesterol levels.Importantly, women’s cholesterol levels can fluctuate and are impacted by menopause and age. For example, estrogen (a hormone that promotes HDL levels) is affected during menopause and can cause higher total cholesterol levels and lower HDL (good cholesterol) levels. As a result, it is important to be informed about your cholesterol levels and communicate with your doctor if you have any concerns or questions.Sources
5 min read
sinus headache vs. migraine

Sinus Headache vs. Migraine: Identification and Treatment

The most common headache is a tension headache that usually comes as the result of stress, anxiety or muscle strains. They range from unpleasant to debilitating.  It can be hard to tell the difference between sinus versus migraine headaches. Early treatment can help reduce or eliminate the headache but if you don’t know which kind you have, it may be difficult to decide what to do or take.Both sinus headaches and migraines may exhibit the same or similar symptoms like a runny or stuffy nose, watery eyes, and most prominently, pressure in the forehead and cheeks.They do differ in that with a sinus headache there can also be a fever and the person’s breath may smell bad.When the passages (sinus cavities) behind the eyes, nose, cheeks and forehead become congested, a headache can occur.  The pressure or pain is not just in the head but anywhere in the sinus area and can be felt on either or both sides of the head.  Occasionally there is also fatigue, aching in the top of the jaw, or redness and swelling in the cheek area.They can occur because of the seasons like allergies, or at other times when something triggers a reaction.  These are severe headaches and they have additional symptoms including nausea, flashing lights or an aura sensation, sensitivity to light and/or sound, even temporary vision loss or vomiting.  Migraines usually only affect one side of the head, but not always.Triggers can include anxiety, alcohol, and hormonal changes.  Sometimes there are indicators a day or so before.At this time it is unclear if sinus headaches and migraines are related.There are a number of over-the-counter remedies for headaches available, like aspirin and ibuprofen.  Sometimes using warm compress on your head or shower can help.  There are also non invasive applications like massage, meditation and relaxation exercises. However, relief may not be immediate. If you can identify triggers, prevention is the best option though changing diet, or managing stress differently.There are prescription medications available to treat migraines that have been proven effective.  For sinus headaches that stem from infections, an antibiotic may sometimes be prescribed.If any type of headache becomes more severe or occurs more frequently, you should consult with a physician.  If you have tried OTC treatments but don’t receive enough relief, or if your daily activities have are becoming compromised, you should also make an appointment to have a thorough check up to rule out more serious issues.There are also some proponents of non-traditional or non-Western medical options.  Just be sure to loop your attending physician in on your choices.
3 min read
Voice is hoarse young woman

My voice is hoarse! How do I keep my voice healthy?

Authors: Dr. Anju Patel, Shielah MauntanaMedically reviewed by ENT Surgeon Dr. Anju PatelMany of us take our voices for granted. We sing, laugh, talk, and yell with our voices every day, so it’s easy to never think about losing our voices. However, it’s important that we keep our voices healthy so permanent damage doesn’t occur. The larynx, or more commonly known as the “voice box”, is a passageway made of various tissues including muscle and cartilage that connects the upper throat or pharynx to the lungs. It is located in the neck and contains the vocal cords (also known as vocal folds). Your vocal cords are made of multiple layers including two muscles that move to produce the sounds that make up your voice. When you are not speaking, your vocal cords are typically not touching and the passage is open so you can breathe. When you are speaking, the vocal cords come together as air from the windpipe comes through, making the vocal cords vibrate and produce voice. (1)  Vocal cords and larynx in addition to parts of the throat differ in size and shape, depending on the person. The differences between each person are what make each person’s voice quality unique. An obvious factor that can differentiate voices is a person’s sex. During puberty, testosterone in males causes an elongation of the larynx’s cartilage and thickening of the vocal cords, which all correlates to lower vibrational frequency when speaking, leading to a deeper sounding voice. Females have shorter and thinner vocal structures which correlate with higher sounding voice. (2)These differences mean females are more prone to vocal disorders due to the relatively higher stress their vocal structures must endure; thinner and shorter structures make higher frequency sounds, which must go through more oscillations and stress to produce voice. (2) Studies have also shown that females must use more respiratory effort to produce the same vocal amplitude or loudness as men. This can lead to increased stress on the vocal cords and lead to vocal damage. (2)  Vocal damage can cause an unhealthy voice. Anyone can develop an unhealthy voice. Those who work in a field of frequent voice use, like teachers and singers, puts their voice at greater risk for developing problems. This is just like athletes being more prone to muscle injury. An estimated 17.9 million adults in the U.S. report voice problems. (1) If your voice develops any of these qualities, you may be developing an unhealthy voice: hoarseness, inability to sing high notes (that you could before), sudden change in the pitch of your voice, an irritated or painful throat, and throat clearing. (1) An unhealthy voice is trying to tell you that there is something else going on in your body. A lot of things can cause an unhealthy voice, some are benign causes and some need serious medical attention. A few causes of an unhealthy voice include: using your voice too much/too strenuously, acid reflux/heartburn (the acid can cause irritation to your larynx), respiratory infection (inflammation of the throat and decreased air flow through the larynx, which affects voice), vocal cord/larynx cancer, neurological diseases (affecting the way your vocal cords move), and psychological trauma. (1) What do I do if I have hoarseness? What do I do if I have damage to my vocal cords?The best thing to do if you think you have a voice problem is to ask a doctor to assess you. A doctor who can best diagnose a vocal disorder is an otolaryngologist aka an ENT. They focus on disorders of the ears, nose, and throat. (1) They can further refer you to a specialist called a laryngologist, who can focus on your vocal concerns, help you build healthy vocal habits, and offer procedures to help if needed. (3) How to keep your voice healthy In order to keep your voice healthy, it is important to keep in mind the stress you put on it when you speak. Avoid shouting, throat clearing, and pushing your volume to its highest limits. Mind your voice when you are sick to prevent permanent damage to your voice. (3) Being dehydrated and drinking alcohol can put stress on the vocal cords as well, so it’s important to drink water. 60-80 ounces is the recommended daily minimum. (3) For the times when you feel you have to raise your voice to be heard - like in a presentation or while teaching in person, the use of a microphone can reduce the stress on your voice. (3) This way, you can be heard while protecting your voice. (3) When you can, it’s important to rest your voice. Continuous use over long periods of time, like during back-to-back Zoom meetings, can strain your vocal cords and lead to long-term damage to your voice. Resting your voice for at least 10 minutes for every hour of speaking is a good rule of thumb. (3) These tips will help keep your voice healthy and heard. 
5 min read

Are bananas good for leg cramps?

Leg cramps, sometimes called Charlie Horses, happen when the muscles contract and won’t immediately release.  The symptoms last for a few seconds to a few minutes and can be extremely painful.  While they are pretty common, not a lot is known about them.These are involuntary contractions in either the muscle or a part of the muscle tissue.  When they occur, common treatments are to stretch or massage them, usually by walking around until the tension releases.The exact causes are unknown but frequently they are attributed to over exercise or dehydration.  There is also no cure.  However, there are ways to control or prevent them from occurring. It is found that if you ingest foods with key nutrients, leg cramps will be less prevalent.  These include potassium, sodium, calcium, and magnesium.  They are all electrolytes and can be found in a number of different food sources. Bananas contain three out of the four electrolytes that you need.  They are loaded with potassium, but also provide magnesium and calcium.  The average banana has 420 milligrams of potassium, or about 10% of the recommended daily requirement.   In addition to bananas, there are a number of foods that will help replenish this mineral and are solid additions to a healthy eating plan.  Sweet potatoes are high on the list.  In fact any type of potato will work.  In addition, they have a high water content so it will help if dehydration is one of the causes for your leg cramps.  Other choices are pumpkin, avocados, and watermelon.Some other preventive measures can include adding regular stretching to your daily exercise.  Sitting or standing all day can be a cause as well as overdoing alcohol or improper footwear.   Factors that can contribute to leg cramps are age considerations.  It is found that middle aged and older adults are more prone to leg cramping.   So, if you are in the middle of a leg cramp, the best thing is to massage it, use some heat or try putting weight on it.  Just be cautious of falls.  Eating a banana in the middle of a cramp won’t make it go away, but as part of a healthy diet and exercise plan, it can act as a deterrent.   If you follow all the rules and still have severe cramps especially frequently, if they don’t dissipate quickly or are in combination with other symptoms, speak with your regular medical provider.  They are linked to some serious conditions like hypothyroidism, diabetes, and Parkinson’s disease.  Only a qualified medical professional can adequately diagnose these conditions.    
3 min read

Bladder Control by Age: What to Expect

If you've noticed a change in your ability to hold your urine output, you may be wondering if evaluating bladder control by age makes the most sense. When evaluating bladder capacity by age there are a few things to consider.The bladder is an expandable organ. When empty its inner lining is compressed and folds in upon itself. The muscle in charge of emptying the bladder is thick and firm. It is made up of two tubes, known as ureters, that expel urine from the kidneys into the bladder. As it fills, the bladder wall becomes thinner and the bladder expands upward toward the abdominal cavity.  bladder capacityFor a child, you can calculate the bladder's capacity by taking the child's age and multiply it by two and then add another two ounces. For example, in a 3-year-old, it is 3 (age) x 2 plus 2, or a total of 8-ounce capacity.A health adult bladder usually holds about two cups of urine. The urge to urinate is triggered at about a quarter of its capacity.As a person increases in years of age, their bladder will grow and change, too. The tissue usually becomes less elastic which means it will not hold as much and cause the person to urinate more frequently. Additionally, the bladder wall and pelvic muscles can become weaker so it is more difficult for the bladder to fully empty.  All of this can cause leakage.This leakage, or urinary incontinence can cause daytime wetting, and cause an overactive bladder, making it harder to stay dry all day. You can attempt to do pelvic floor exercises to help combat this type of incontinence.The urinary system is composed of the bladder, kidneys, ureters, and urethra. The body processes what it needs from what we eat and drink and the excess fluid is passed through the kidneys.  In addition to the extra fluid, there will be other waste products in our urine as it moves into the bladder. When appropriate, the bladder will release urine through the urethra tube.A muscular valve, the internal sphincter, controls the release of urine and can help prevent leaking.  However, there are some common problems that will disrupt normal operation.There are infections that occur in the urinary tract (UTIs). These can occur anywhere in the system.  They are more common in women than men and happen as the bladder muscles weaken. Then the bladder is unable to fully empty itself.  If urine remains in the bladder for too long, it is more prone to infections.There are also lower urinary tract symptoms (LUTS) that indicate potential problems in the bladder and pelvic floor muscles.  These are indicated by trouble eliminating the urine, leaking, and frequent urges.There are many things that can affect the health of the bladder.
4 min read

Preventing Eye Injuries in Children: Advice from a Cornea Specialist

Our most prized possession (okay maybe I’m a bit biased), is our vision. Moms out there, I cannot imagine how challenging it may be at home to make sure everything is optimized to keep your children safe from potential accidental eye injury. In this post, I will explore both chemical eye injury and then overall eye injuries in the pediatric population. A topic that was special to me in my residency and that I developed into a poster presentation in 2019 at The Association for Research in Vision and Ophthalmology (ARVO) was chemical-related eye injuries in pediatric patients across the country. We analyzed seventeen years of data from one hundred pediatric emergency departments in the country. Let me start first with the trends we found and then we can explore ways through which you can prevent eye injuries for your children.  In terms of chemical-related eye injury, the most common culprit was laundry soap and laundry detergent pods! This most commonly occurred for children in the summer, at home, and usually in kids between ages one to four years old. Other culprits included swimming pool cleaners and household cleaners. What do I mean in terms of chemical-related eye injuries? Well, any substance or chemical depending on its composition can cause a spectrum of injuries to our eyes, ranging but not limited to infection and compromise to the cornea’s ability to maintain its layers. Every injury to the eye, whether it be traumatic or related to a chemical, should be treated seriously and should be evaluated by an Ophthalmologist in an emergency setting.  Now let’s shift gears into looking at more broad pediatric eye injuries.  Pediatric eye injuries are wide-ranging, but often include animal bites/scratches, chemicals, and trauma (for instance an object to the eye). This was the foundation of many of my consults during training. Thus, I have developed from my experience six pearls for parents - in either preventing or managing an eye injury for your child: 1)      Keep things out of reach! One of the most simple ways to prevent injury is to keep items such as detergents, cleaners, sharp objects, hot objects etc. out of reach! 2)      If your child has sustained a traumatic eye injury, try not to manipulate the eye before an Ophthalmologist conducts their exam.If your child has sustained aa trauma to the eye, do not manipulate/touch the eye in case there is serious injury. Ensure your child does not touch his or her eye and then bring him or her in to see an Ophthalmologist as soon as possible (same day)!3)      In the instance of a chemical injury to the eye, the best thing you can do is flush and irrigate your child’s eye(s) with water. If you have saline at home, you can use this also. Irrigate until you can’t irrigate anymore! This is the best initial treatment for this injury and can prevent progression of chemical injury to the cornea and ocular surface.4)      Do not assume a red eye is just a red eye.Often parents notice redness on a child’s eye and attribute it to irritation or nothing serious. Do not underestimate what a red eye could really mean. It is only with appropriate instrumentation and a thorough exam by an Ophthalmologist that severe eye injury can be ruled out. 5)      Do not buy over the counter topical therapy (drops, ointments) to use on your child’s eyes until an Ophthalmic exam has been performed.Often the general population does not realize that over the counter drops and ointments are not all benign and totally harmless. Certain ingredients and formulations can worsen a preexisting eye condition or injury, so it is always best to hold off on treatment until your child has been seen by an Ophthalmologist. 6)      If you have a pet at home, ensure that his or her vaccinations are maintained and updated, and that their claws (if applicable) are appropriately managed and trimmed. Even the kindest, sweetest pets sometimes do not know better, and children can sustain significant injuries near or within their eyes as a result. With these pearls, you will be better prepared in anticipation of any potential eye injury that your child may face. Through education, discussion, and anticipation you can really do a lot in minimizing the risk of a child undergoing an incidental eye injury. I encourage dynamic discussion between each caretaker of a child to ensure that these precautions are being implemented in all of the settings a child may be in on a given day.  As always, I welcome, encourage, and love answering questions.  I hope this blog post helps even one parent out there! Nitasha Khanna, MDCornea and External Disease FellowOphthalmologist Follow her on Instagram Reference: Khanna N, Yilmaz T, Simon M, Migliori M. Epidemiology of Pediatric Chemical-related Eye Injuries Treated in US Emergency Departments (2000-2017). Annual Meeting, The Association for Research in Vision and Ophthalmology, Vancouver, Canada, May 2019.
5 min read
neon yellow pee causes

Neon Yellow Pee- What causes it?

Urine should be yellow.  Each person has a different “normal” in the color range from very pale to darker shades of yellow.  You should recognize when your urine color is average for you.  When you drink the proper amount of water a day, urine is probably pretty light yellow.  The more dehydrated you are, the darker it will look.  If your urine is cloudy, a color other than yellow, or brown, consult your medical professional. Diet can also be a factor in the color of your urine.  Beets and berries can cause your urine to be pink or reddish.  Some processed foods also contain dyes that will affect the color.  The beta carotene that we are encouraged to consume in carrots and sweet potatoes converts to Vitamin A that can make your urine darker or even orange. If you have recently switched or added certain vitamins to your regimen, you should realize that the B vitamins like B-2 and B-12 can cause urine to fluoresce into almost a yellow-green color.  This includes those shakes that have a lot of riboflavin and cobalamin.  Vitamin C may show up darker or even orange.  Vitamin C is also high in foods like tomatoes, strawberries and broccoli. As mentioned, keeping hydrated is a good thing, especially if you exercise vigorously.  If you have worked out or have been dealing with summer heat, you probably should increase your water intake.  If your urine is darker than usual after exertion, have a glass of water.  If you are consistently dehydrated, you will notice your urine is brownish like a cola or tea.  Especially if you are also experiencing muscle pain, seek medical attention quickly.  This is serious.Medications can also affect the appearance of urine.  This includes over-the-counter as well as prescription versions.  Examples include phenazopyridine (Pyridium) and rifampin are known to produce an orange hue.  Laxatives and some chemotherapy treatments also change the color of urine. If you have ruled out dehydration, food sources, and medicines, but you still notice discoloration, cloudiness, or an unusual odor, you may have developed an infection or issues with your kidneys or bladder.  This can be a sign of a serious illness or condition.  Consult a physician as soon as possible to rule out anything critical.  Especially if the discoloration is accompanied by any other symptoms like fever, pain, or vomiting. Age and gender play important roles in the chances of developing some condition or illness.  Most women will, at some point, develop a uterine tract infection (UTI) and men can have problems with their prostate gland, either of which can cause bleeding expelled through the urinary tract.  For children, urinary tract bleeding is very serious and should be addressed quickly by medical personnel. When you visit the doctor and he or she orders a urinalysis, you should be prepared to answer a number of questions especially when the discoloration began, sleep patterns, smoking, unexplained weight loss, rashes, and any changes in your regular routine.  Through a physical examination and the results of your blood work, the physician should be able to direct you to a cause and treatment options. 
3 min read
is dry shampoo safe

Is Dry Shampoo Safe? Potential Damage & Usage Recommendations

Dry shampoo is a product designed to freshen hair between showers or traditional shampooing - but Is dry shampoo safe for regular use? Dry Shampoo is an alcohol- or starch-based substance.For some people, dry shampoo is beneficial during camping trips or traveling where daily showers are not always available. For other it is just a convenience to avoid washing hair quite as often. This is good if you have hair that needs more moisture or after menopause when hair is less oily.  It can give a boost for an extra day or so between washes.Dry shampoo is safe to use on an occasional basis but if overused, it can damage hair and even cause problems with the scalp. That will result in hair breakage, clogged follicles and even hair loss. Physicians recommend that it be used for no more than two days in a row.Proper usage is also important. Holding the canister about 6 inches from the head, spray only the hair, not the scalp. Use it only on oily areas like the temples or crown, where the oil is more noticeable. Using a comb or your fingers make sure any accumulated spray is moved from the roots and distributed evenly over the oily areas.Dry shampoo is not a cleaning agent. It is just designed to absorb extra oil. It has no effect on dirt and really doesn’t even remove all of the oil.Some of these hair care products have alcohols that will dry out hair and when you comb or brush your hair, it will snag on the comb or on each other and then break off. If you leave the dry shampoo on too long, it will build up on the scalp which can cause the follicles to clog or even develop a bacterial or fungal infection.Dry shampoo does not seem to directly cause hair loss, but hair that grows from a follicle damaged by the fungal or bacterial infection is not very well anchored and is more likely to fall out. The scalp is covered with follicles that not only grow hair but produce a natural oil called sebum. Sebum softens the scalp, gives hair texture, and protects the skin.Cancer LinkSome of these dry shampoos are made from or contain talc. In its natural state, talc is composed of asbestos particles. Products produced in the US or imported for use are prohibited from the use of asbestos because of its carcinogenic qualities. You may have read about the possible link between talcum powder (non-asbestos) and ovarian cancer. There is no known link between that condition and the use of dry shampoos but the American Cancer Society recommends avoiding talc-related products pending additional research.AlternativesOf course, the best thing is to keep your hair clean and well conditioned.  There are shampoo and other products that are organically made.  There are also some home made versions that use cornstarch and rice starch.  Add a few drops of essential oils and you are ready.So the take-away is that if you want to use a dry shampoo, do it in moderation and avoid those products made with talc.  
3 min read
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